A new strain of influenza A virus (novel influenza A H1N1) that originated in swine has rapidly spread from the initial outbreak in Mexico and the southern United States to Canada and many countries in Europe and Asia. Consequently, the World Health Organization raised the level of alert for an influenza pandemic to 5 on Apr. 29, 2009.1 Because many infected people are young,2 the care of pregnant and lactating women is a concern.3–6
According to the US Centers for Disease Control and Prevention, the novel H1N1 influenza virus is susceptible to oseltamivir and zanamivir, neuraminidase-inhibitor antiviral medications, which target the early phase of the infection. However, this strain is resistant to adamantanes, such as amantadine and rimantadine.7 The Centers for Disease Control and Prevention currently recommend antiviral treatment and chemoprophylaxis with either oseltamivir or zanamivir against novel H1N1 influenza for people at high risk of complications, including pregnant women.3,4,8
In this report, we summarize information about the safety of neuraminidase inhibitors for treatment of novel H1N1 influenza in pregnant and breastfeeding women. Although the information about drug safety in this report is also applicable to seasonal influenza and future pandemics, the management strategy presented in this article is specific to novel H1N1 influenza.